(a) Name of the applicant and name and headquarter's address of any state or national organization of which it is a local branch or lodge;
(b) The address and telephone number of the applicant organization, if any. If the applicant organization has no telephone, then the address and telephone number of the person applying on behalf of such organization shall be supplied;
(c) For a limited occasion license, the names and addresses of two or more bona fide active members of the applicant organization who are charged with overall responsibility for the applicant's bingo operations, at least one of whom shall be present at all times bingo is conducted; and the names and addresses of the highest elected officer of the licensee and his officially appointed designee, one of whom shall be present at all times bingo is conducted; for an annual license, the names, addresses and telephone numbers of three or more bona fide active members of the applicant organization who are charged with overall responsibility for the applicant's bingo operations, at least one of whom shall be present at all times bingo is conducted; and the names and addresses and telephone numbers of the highest elected officer of the licensee and his officially appointed designee, one of whom shall be present at all times bingo is conducted;
(d) The address or location of the premises where licensed bingo games are to be held;
(e) Information as may be required by the commissioner to satisfy him that the applicant meets the requirements of:
(1) Being a charitable or public service organization as required by this article; and
(2) Being in existence in this state two years prior to filing an application for a bingo license.
(f) The day or days of the week, and the time or times when the bingo occasions will be held;
(g) The name of the owner of the premises where the bingo occasions are to be held and a copy of all rental agreements involved if leased or subleased by the applicant from the owner or lessee;
(h) A statement as to whether the applicant has ever had a previous application for any bingo license refused, or whether any previous license has been revoked or suspended;
(i) A statement of the charitable or public service purpose or purposes for which the bingo proceeds will be expended;
(j) A statement or statements to the effect that the individuals specified in subdivision (c) of this section and the officers of the applicant understand:
(1) That it is a violation of this article to allow any persons other than those authorized by this article to conduct any part of the bingo games or concessions operated in conjunction therewith;
(2) That it is required to file the reports and keep the records as provided by this article; and
(3) That it is a crime to violate the provisions of this article and, in addition, that a violation may result in suspension or revocation of its license and denial of applications for subsequent licenses;
(k) A sworn statement by an authorized representative of the applicant that the information contained in the application is true to the best of his knowledge;
(l) A list and description of estimated expenses to be incurred in connection with the holding of the bingo occasions and any concessions operated and the name and address of each payee. If a concession is operated in accordance with the provisions of section thirteen of this article, a copy of any written agreement or an explanation of any oral agreement providing for any type of remuneration to be received by theconcession operator shall be attached to the application;
(m) A list of the names and addresses of all officers and members of the board of directors, governors or trustees, if any, of the applicant organizations; and
(n) Any other necessary and reasonable information which the commissioner may require.
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